Provider Demographics
NPI:1538708573
Name:SKIN DOCS
Entity type:Organization
Organization Name:SKIN DOCS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DERMATOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BELLEW
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:702-349-9001
Mailing Address - Street 1:410 S RANCHO DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-4802
Mailing Address - Country:US
Mailing Address - Phone:702-349-9001
Mailing Address - Fax:
Practice Address - Street 1:2860 E DESERT INN RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-3605
Practice Address - Country:US
Practice Address - Phone:702-551-9487
Practice Address - Fax:702-924-0634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-21
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty